Decidual CD56+ Natural Killer Cells in Spontaneous Early Pregnancy Loss- An Immunohistochemical Study.

INTRODUCTION: Natural killer cells are believed to promote placental and trophoblastic growth and provide immune- modulation at maternal-fetal interface in pregnancy and their role in reproductive failure has been a matter of discussion. AIM: To study CD56+ Natural killer cells in spontaneous pregnancy loss. MATERIALS AND METHODS: In this prospective observational study, formalin-fixed paraffin embedded sections from products of conception from twenty women each with spontaneous early pregnancy loss (test group) and elective pregnancy termination (control group). Immunohistochemical staining with CD 56 monoclonal antibody was done by avidin-biotin peroxidase technique. CD56+ cells in decidua were counted under light microscopy by two independent observers in ten high power fields (40X) and mean cell count taken. Student's paired 't'-test was used to statistically compare CD56+ NK cell population between the test and control groups. RESULTS: The mean number of CD56+ NK cells was higher in the decidual tissue of women who had spontaneous early pregnancy loss (mean±SD, 57.55±1.79) as compared to the mean number of CD56+ NK cells in the decidual tissue from women who underwent elective termination (mean±SD, 50.9±3.46). The difference was statistically significant (difference of 6.65 with 95% confidence interval of 4.76 to 8.54, p-value <0.0001). CONCLUSION: This could imply that CD56+ NK cells have a role in the pathogenesis of spontaneous early pregnancy loss and further large scale studies can throw more light on the mechanism and designing of appropriate therapy.

Automated measurement of immature granulocytes: performance characteristics and utility in routine clinical practice.

The granulocytic "shift to left" reflects marrow response to bacterial infection, and this may be quantified as band count or immature granulocyte count (IGC). The former value, used widely in neonatal sepsis, has been notoriously difficult to measure accurately and precisely. A reproducible, precise, and accurate counting of immature granulocyte counts may be possible with automation. This study of 200 febrile patients aimed at analysing the performance characteristics of automated immature granulocytes (AIGs) in predicting blood culture and their clinical utility. The absolute (IGC) and relative IG count (IG%) had area under curve (AUC) of 0.69 and 0.66. Moreover, the means of IGC and IG% between culture positive and negative groups were statistically significant suggesting that they are potential markers for bacteremia. IGC of 0.03 × 10(3) cu·mm and IG% of 0.5% offered sensitivity of 86.3% and 92.2%, respectively, and may be used for screening for bacteremia. Higher values, IGC > 0.3, and IG% > 3 had specificity greater than 90%, although the values were infrequent. It may not be long before that these automated hemograms are put into regular diagnostic use.